Fri Jun 24 2022

60 articles - From Friday Jun 17 2022 to Friday Jun 24 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Ann Rheum Dis

Developing guidelines for ultrarare rheumatic disorders: a bumpy ride.

When it comes to the realm of ultrarare diseases, there are few physicians who are familiar with a disease, and there is a scarcity of literature. In this viewpoint, we describe challenges from the methodological perspectives that occurred during the process of developing recommendations for autoinflammatory disorders with the goal of finding solutions that facilitate the development of guidelines for ultrarare diseases in the future.

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Arthritis Care Res (Hoboken)

2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty.

This updated guideline includes recently introduced immunosuppressive medications to help decision-making by clinicians and patients regarding perioperative disease-modifying medication management for patients with IA and SLE at the time of elective THA or TKA.

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Arthritis Rheumatol

2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty.

This updated guideline includes recently introduced immunosuppressive medications to help decision-making by clinicians and patients regarding perioperative disease-modifying medication management for patients with IA and SLE at the time of elective THA or TKA.

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Meta-analysis

meta-analyses and systematic reviews


Original articles

RCT, clinical trials, retrospective studies, etc…

Ann Rheum Dis

Effectiveness of TNF-inhibitors, abatacept, IL6-inhibitors and JAK-inhibitors in 31 846 patients with rheumatoid arthritis in 19 registers from the 'JAK-pot' collaboration.

The adjusted overall drug discontinuation and 1year response rates of JAKi and IL-6i were similar to those observed with TNFi. Compared with TNFi, JAKi were more often discontinued for adverse events and less for ineffectiveness, as were IL-6i.

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Epithelial HIF2a expression induces intestinal barrier dysfunction and exacerbation of arthritis.

These findings show that the HIF2a-CLDN15 axis is critical for the breakdown of intestinal barrier function at onset of arthritis, highlighting the functional link between intestinal homeostasis and arthritis.

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EULAR/PRES recommendations for vaccination of paediatric patients with autoimmune inflammatory rheumatic diseases: update 2021.

These recommendations are intended for paediatricians, paediatric rheumatologists, national immunisation agencies, general practitioners, patients and national rheumatology societies to attain safe and effective vaccination and optimal infection prevention in immunocompromised pedAIIRD patients.

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Hypomethylation of miR-17-92 cluster in lupus T cells and no significant role for genetic factors in the lupus-associated DNA methylation signature.

The lupus defining epigenetic signature, characterised by robust hypomethylation of interferon-regulated genes, does not appear to be determined by genetic factors. Hypomethylation of the miR-17-92 cluster that plays an important role in T cell activation is a novel epigenetic locus for lupus.

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Impact of pre-existing background therapy on placebo responses in randomised controlled clinical trials of rheumatoid arthritis.

Clinical responses to placebo are higher in patients who continue an insufficient MTX background therapy. This suggests an inadvertently more consequent intake of background therapy during the trial. Background therapy should therefore be effectively aligned before enrollment into a clinical trial.

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Longitudinal trajectories of fatigue in early RA: the role of inflammation, perceived disease impact and early treatment response.

Although fatigue evolves dynamically over time in early RA, most patients do not achieve sustained fatigue improvement despite intensive disease-modifying antirheumatic drug therapy. Higher 5-year fatigue levels were seen in patients with more perceived disease impact and fewer swollen joints at baseline. Conversely, early inflammatory disease control strongly improved long-term fatigue, pointing towards an early window of opportunity to prevent persistent fatigue.

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Methylome and transcriptome profiling of giant cell arteritis monocytes reveals novel pathways involved in disease pathogenesis and molecular response to glucocorticoids.

Our results revealed profound alterations in the methylation and transcriptomic profiles of monocytes from GCA patients, uncovering novel genes and pathways involved in GCA pathogenesis and in the molecular response to GC treatment.

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NOD/RIPK2 signalling pathway contributes to osteoarthritis susceptibility.

Two types of data support the hypothesis that altered NOD/RIPK2 signalling confers susceptibility to OA.

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Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial.

Non-inferiority of maintenance IST discontinuation after 23 years was not demonstrated for renal relapse. IST discontinuation was associated with a higher risk of severe SLE flares.

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Arthritis Care Res (Hoboken)

Assessing the Utility of the Montreal Cognitive Assessment (MoCA) in Screening for Cognitive Impairment in Patients with Systemic Lupus Erythematosus.

The MoCA does not have adequate concurrent criterion validity to accurately identify CI in patients with SLE. The low specificity of the MoCA may lead to overdiagnosis and concern among patients. Adding the MoCA to the ANAM does not substantially improve the accuracy of the ANAM. These results do not support using the MoCA as a screening tool for CI in patients with SLE.

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Association of Ultraviolet-B Radiation and Risk of SLE among Women in the Nurses' Health Studies.

Cumulative UV exposure was not associated with SLE risk. Higher UV exposure, however, was associated with increased risk of malar rash at presentation. UV exposure may trigger SLE onset with malar rash among susceptible women.

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Using Unsupervised Machine Learning Methods to Cluster Comorbidities in a Population-based Cohort of Patients with Rheumatoid Arthritis.

Despite the higher comorbidity burden in patients with RA compared to the general population, clustering comorbidities did not identify substantial differences in comorbidity patterns between the RA and non-RA cohorts. The instability of clustering methods suggest caution when interpreting clustering using one method.

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Virtually Speaking: The Impact of a Nationwide Synchronous and Asynchronous Learning Forum.

With collaboration, adaptation, and innovation, the V-FIT program not only maintained but enhanced education for rheumatology trainees, was enriched by national and international participation, and provided standardized, broadly accessible content with interdisciplinary learning.

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Arthritis Res Ther

Association of clinic setting with quality indicator performance in systemic lupus erythematosus: a cross-sectional study.

SLE patients managed in a subspecialty lupus clinic recorded higher per-patient QI performance compared to hospital general rheumatology and private rheumatology clinics, in part related to better documentation on certain QIs.

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Defining minimal detectable difference in echocardiographic measures of right ventricular function in systemic sclerosis.

We demonstrate minimal measurement error in clinically important 2DE-based measures in SSc patients with and without PAH. Defining the MDD in this population has important implications for PAH screening, assessment of therapeutic response, and sample size calculations for future clinical trials.

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Extracellular matrix protein turnover markers are associated with axial spondyloarthritis-a comparison with postpartum women and other non-axial spondyloarthritis controls with or without back pain.

Biomarkers of type I, IV, and VI collagen and biomarkers of inflammation showed an altered turnover in patients with axSpA compared with the non-axSpA control groups. Such biomarkers may be useful in combination with MRI or independently to separate patients with axSpA from other back pain conditions.

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High serum uric acid trajectories are associated with risk of myocardial infarction and all-cause mortality in general Chinese population.

Higher SUA trajectories were associated with altered risk of MI and all-cause mortality, suggesting that monitoring SUA trajectory may assist in identifying subpopulations at higher risk of MI and all-cause mortality.

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Influence of initial glucocorticoid co-medication on mortality and hospitalization in early inflammatory arthritis: an investigation by record linkage of clinical and administrative databases.

In patients with early inflammatory arthritis, the initial GC dose was higher than that prescribed by rheumatologists; however, on background treatment with DMARDs, GC treatments did not seem to increase mortality and hospitalizations.

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Long-term exposure to fine particulate matter and ozone and the onset of systemic autoimmune rheumatic diseases: an open cohort study in Quebec, Canada.

Objectives To estimate associations between fine particulate matter (PM , but no relationships with ozone. Additional studies are needed to better understand interplays between the many constituents of air pollution and rheumatic diseases.

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Metabolomics with severity of radiographic knee osteoarthritis and early phase synovitis in middle-aged women from the Iwaki Health Promotion Project: a cross-sectional study.

Large sample metabolome analyses revealed that cystine, an amino acid associated with antioxidant activity and glutamate homeostasis, might be a potential metabolic biomarker for radiographic osteoarthritis and early phase synovitis.

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Myeloid cell-specific deletion of Capns1 prevents macrophage polarization toward the M1 phenotype and reduces interstitial lung disease in the bleomycin model of systemic sclerosis.

This study for the first time demonstrates that the role of myeloid cell calpain may be promotion of macrophage M1 polarization and pro-inflammatory responses related PI3K/AKT1 signaling. Thus, myeloid cell calpain may be a potential therapeutic target for bleomycin model of SSc-related ILD.

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Peripheral blood CD4posCD25posFoxP3pos cells and inflammatory cytokines as biomarkers of response in rheumatoid arthritis patients treated with CTLA4-Ig.

Baseline IL-6 serum levels and peripheral blood-derived CD4 pos subpopulations are putative novel prognostic biomarkers of CTLA4-Ig response in RA patients.

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The association between ambient UVB dose and ANCA-associated vasculitis relapse and onset.

Our findings suggest that low winter ambient UVB and prolonged vitD status contribute to AAV relapse risk across al phenotypes. However, the development of a granulomatous phenotype does not appear to be directly vitD-mediated. Further research is needed to determine whether sufficient vitD status would reduce relapse propensity in AAV.

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Arthritis Rheumatol

Combined genetic deficiencies of the classical complement pathway are strongly associated with both systemic lupus erythematosus and primary Sjögren's syndrome.

We demonstrate that the combination of partial deficiencies of C2 and C4A in the classical complement pathway is a strong risk factor for SLE and pSS. Our results emphasise the central role of the complement system in the pathogenesis of both diseases.

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Phase II/III results of the anti-TNF multivalent NANOBODY® compound 'ozoralizumab' in patient with rheumatoid arthritis (OHZORA trial).

In patients with active RA who receive MTX therapy, ozoralizumab significantly reduced the signs and symptoms of RA, compared with placebo. Ozoralizumab showed acceptable tolerability with no new safety signals, when compared with other antibodies against tumour necrosis factor alpha.

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The relation of pain reduction with prevention of knee replacement under dynamic intervention strategies.

Modest pain reductions from OA interventions would substantially reduce the number of KRs with greater reductions achieved when pain decreased more and when interventions were introduced at lower pain levels.

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Two Distinct Immune Cell Signatures Predict the Clinical Outcomes in Patients with Amyopathic Dermatomyositis with Interstitial Lung Disease.

Peripheral immunological features may have the potential to stratify patients with ADM-ILD with different disease severity and clinical outcomes, which may have implications for outcome prediction, pathogenesis study and therapy selection.

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Variability in primary Sjögren's syndrome is driven by interferon alpha, and genetically associated with the class II HLA DQ locus.

The present analysis identified the predominance of IFNa as driver of pSS variability and revealed an association with HLA gene polymorphisms.

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Rheumatology (Oxford)

Accuracy of power Doppler ultrasonography in the diagnosis and monitoring of idiopathic inflammatory myopathies.

Our findings show that PDUS is a reliable diagnostic tool in the differential diagnosis between inflammatory and non-inflammatory myopathies. Moreover, PDUS can be employed also during the follow-up of patients with IIM. A reduction in disease activity, measured by PhGA, led to a concomitant decrease in both oedema and PD, which was directly correlated with their rate of change. This underlines the close link between clinical assessment and PDUS findings, not only at diagnosis but also during monitoring.

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Behçet syndrome in children and adults: discovering similarities and differences by a comparative study.

Remarkable differences between juvenile-onset and adult-onset BS, both in terms of gender, familiar predisposition, and clinical manifestations have been observed and a different therapeutic approach in the real clinical practice of the two settings emerged. Prospective, comparison studies with a longer follow-up are encouraged to provide further data about the disease course for juvenile and adult-onset BS.

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Circulating and renal fibrocytes are associated with interstitial fibrosis in lupus nephritis.

Fibrocytes were significantly increased in the blood and kidney tissue of patients with LN, especially those with interstitial fibrosis. Fibrocytes could be differentiated from blood cells, with an active contribution from RTECs. Our results show a possible link between fibrocytes and tubulointerstitial fibrosis, which may serve as a novel therapeutic target for LN fibrogenesis.

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Clinico-pathological phenotypes of Systemic Sclerosis associated myopathy: analysis of a multicenter large cohort.

Patients with SSc-associated myopathy require a comprehensive approach that encompasses clinical, serological, and histopathological aspects given their outcome predictive capacity. At least two different phenotypes can be drawn considering clinic-pathological features. Significant differences are delineated between both a fibrotic and an inflammatory phenotype.

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Controversies in rheumatology: Maintenance therapy with low-dose glucocorticoids in rheumatoid arthritis.

However, their potential to cause adverse effects, especially with prolonged use in high doses, limits their applicability. We discuss the arguments against and in favor of maintenance therapy with low-dose glucocorticoids in patients with rheumatoid arthritis, and present recent studies, assessments and conclusions on this question.

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COVID-19 vaccination-related adverse events among autoimmune disease patients: results from the COVAD study.

Vaccination against COVID-19 is relatively safe in SAID patients. SAIDs were at a higher risk of major ADEs than HCs, though absolute risk was small. There are small differences in minor ADEs between vaccine types in SAID patients.

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Female reproductive status and exogenous sex hormone use in rheumatoid arthritis patients treated with tocilizumab and csDMARDs.

Perimenopausal women were less likely to achieve remission compared with pre-menopausal RA patients. The use of exogenous sex hormones appeared to be associated with more frequent remission in female RA patients, particularly those who were perimenopausal and early-postmenopausal, although further research is required to confirm and identify the drivers for this observation and how it interacts with menopausal status.

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Immunosuppressive treatments selectively affect the humoral and cellular response to SARS-CoV-2 in vaccinated patients with vasculitis.

Although patients with GCA apparently achieve a robust antibody seroconversion, there is a significant impairment of the neutralising activity. MTX significantly reduced al levels of the humoral response. Up to one third of patients do not develop a cellular immune protection in response to COVID-19 vaccination.

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Is the risk of infection higher during treatment with secukinumab than with TNF-inhibitors? An observational study from the Nordic countries.

When used according to clinical practice in the Nordic countries, the observed first-year absolute risk of hospitalized infection was doubled for secukinumab compared with adalimumab. This excess risk seemed largely explained by confounding by indication.

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Late Skin Fibrosis in Systemic Sclerosis: A Study from the EUSTAR Cohort.

Late skin fibrosis is not uncommon in SSc. We have identified different patterns relevant to clinical practice and trial design. Late skin fibrosis is a neglected manifestation of SSc and warrants further investigation including to determine clinical outcomes and optimal therapeutic strategy.

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Lung vascular changes as biomarkers of severity in systemic sclerosis-associated interstitial lung disease.

In SSc patients CT vessel parameters increase in parallel with ILD extent and functional impairment and may represent a biomarker of SSc-ILD severity.

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The role of YAP1 target gene CTGF in the anoikis resistance of rheumatoid arthritis synovial fibroblasts.

The elucidation of a new molecular mechanism that protects RASFs in the highly pro-apoptotic environment of inflamed RA joints by promoting anoikis-resistance and transendothelial migration via ADAM15/YAP1-mediated CTGF upregulation uncovers potentially new targets for future therapeutic intervention.

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TOX promotes follicular helper T cell differentiation in patients with primary Sjögren's syndrome.

Our data suggest that TOX in pSS naive CD4+ T cells are upregulated which facilitates Tfh cell differentiation. Mechanistically, interferon-a induces TOX overexpression in naive CD4+ T cells through JAK-STAT1 signaling and TOX regulates BCL6 expression. Therefore, JAK-STAT1 signaling and TOX might be potential therapeutic targets in pSS.

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Trajectories of disease activity in patients with JIA in the Childhood Arthritis and Rheumatology Research Alliance Registry.

Five trajectories of JIA disease activity, and associated baseline variables were identified.

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Upregulated expression of FFAR2 and SOC3 genes is associated with Gout.

FFAR2 upregulation is associated with gout and may trigger gout flares. SOCS3 may have a role in amelioration of gout flares.

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Use of primary health care and radiological imaging preceding a diagnosis of rheumatoid arthritis: a nationwide cohort study in Denmark.

Increased contacts to GPs and physiotherapists were seen in al 12 months preceding the RA diagnosis, intensifying in the last six to eight months. Imaging increased from three months before the diagnosis. This indicates an opportunity to expedite referral to specialist care and ensure earlier diagnosis of RA.

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Validation of the parent global assessment as a health-related quality of life measure in juvenile idiopathic arthritis: Results from ReACCh-Out.

Our results offer support for the parent global as a valid measure of HRQoL for JIA. If confirmed, existing studies using the parent global may be re-interpreted enhancing our knowledge of HRQoL in children with JIA.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Ann Rheum Dis

Greetings from the editor.

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Synovial fibroblasts as potential drug targets in rheumatoid arthritis, where do we stand and where shall we go?

Their importance in autoimmune joint disorders makes them attractive cellular targets, and as mesenchymal-derived cells, their inhibition may be carried out without immunosuppressive consequences. Here, we aim to give an overview of our current understanding of the target potential of these cells in RA.

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Arthritis Rheumatol

Immune Cell Signatures to Stratify Patients with Systemic Autoimmune Diseases: a Step Towards Individualized Medicine?

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Letters&Replies

Letters to the editors and authors’ replies

Ann Rheum Dis

Correspondence on 'Mechanical overloading promotes chondrocyte senescence and osteoarthritis development through downregulating FBXW7' by Zhang et al.

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Arthritis Rheumatol

A methodological problem and a conceptual issue related to the new 2022 ANCA related vasculitis criteria sets.

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Reply: A misinformative title and an abstract conclusion in the recent GWAS study in Behçet's Disease: Comment on the article by Su et al.

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Response to Letter to the Editor by Drs. Yazici and Yazici regarding the 2022 ACR/EULAR Classification Criteria for the ANCA-associated vasculitides.

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Others

all remaining publications eg case reports, images of the month, etc…

Ann Rheum Dis

Joachim Robert Kalden: one of the founders of autoimmunity research and immunotherapy.

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Response to: Correspondence on 'Mechanical overloading promotes chondrocyte senescence and osteoarthritis development through downregulating FBXW7' by Loeser et al.

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Rheumatology (Oxford)

A rare onset in tumor necrosis factor receptor-associated periodic syndrome: recurrent macrophage activation syndrome triggered by COVID-19 infection.

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Novel genetic mutation in myositis-variant of VEXAS syndrome.

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VEXAS syndrome complicated with severe infection.

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